CMS Ground Ambulance Data Collection System

The CMS Ground Ambulance Data Collection System report was designed to assist ZOLL customers with the mandated CMS Ground Cost Reporting. Due to the fact that ZOLL Billing is designed for billing purposes only, this report will not assist with Trip Count information prior to transport. This report will assist with Section 5, Section 6 and Section 13 of the CMS Ground Ambulance Data Collection System.

Section 5 - Ground Ambulance Service Volume

Paid Ground Ambulance Transport (as defined by CMS): A paid ground ambulance transport refers to a ground ambulance transport that was furnished during your organization’s data collection period, for which your organization has been paid in full or in part by a payer and/or patient only by the time you are reporting data to CMS. Please note that some questions ask only about paid ground ambulance transports, and other questions ask about both paid ground ambulance transports and ground ambulance transports that are not paid, either because your organization did not bill for them or because your organization billed but did not collect payment for them.

Report criteria: Count of all trips with a payment greater than $0.00 by Date of Service (Trip date). This only counts claims with Base Rate HCPCS codes of A0426, A0427, A0428, A0429, A0433 and A0434. Per CMS, claims should be counted in this section even if payment was received after the reporting period.

Section 6 - Service Mix

Emergency vs. Non-Emergency (as defined by CMS): This section covers a mix of your organization’s ground ambulance responses during your organization’s data collection period. There are two levels of service for Basic Life Support (BLS) and Advanced Life Support, Level 1 (ALS1) transports: emergency and non-emergency. CMS has defined an emergency response as: An emergency response is a BLS or ALS1 level of service that has been provided in immediate response to a 911 call or the equivalent. An immediate response is one in which the ground ambulance organization begins as quickly as possible to take the steps necessary to respond to the call. This can include emergency transfers from a lower-level to higher-level of care. The percentage of emergency and non-emergency responses should add to 100%. Advanced Life Support, Level Two (ALS2), Specialty Care Transport (SCT) and Paramedic Intercept (PI) transports may be emergency if an immediate response is provided. Enter 0% if you do not provide responses in either category.

Report criteria: Displays a count of all Emergency vs. Non-Emergency trips based on HCPCS code. Non-Emergency claims are defined as A0426, A0428, A0433 (where Emergency Indicator = No) and A0434 (where Emergency Indicator = No). Emergency claims are defined as A0427, A0429, A0433 (where Emergency Indicator = Yes) and A0434 (where Emergency Indicator = Yes). This report excludes Canceled trips.

Total Ground Ambulance Transports (as defined by CMS): Please indicate what percentage of your organization’s total ground ambulance transports fell in the following categories during your organization’s data collection 11 period. Emergency transfers would be included under the category in which they were billed. The billing codes are included for reference. The percentages should add to 100%. Enter 0% if you do not provide transports in a category.

Report criteria: Displays a percentage (RN Billing) or count (ZOLL Billing) of trips by HCPCS codes for Base Rates of A0426, A0427, A0428, A0429, A0433 and A0434.

Interfacility Transports (as required by CMS): In thinking across all of your ground ambulance transports, what is the percentage of transports that are interfacility?

As defined by CMS: Interfacility transport: are transports where “the origin and destination are one of the following: a hospital or skilled nursing facility that participates in the Medicare program or a hospital-based facility that meets Medicare’s requirements for provider-based status.”

Report criteria: Interfacility is defined in ZOLL Billing as any claim or trip with a modifier of HH, HN, NH. Canceled calls are excluded.

Section 13 - Revenues

This section asks about your organization’s sources of ground ambulance revenue. You may need to collect information from a billing company or your municipality to report this information. Do not include billed but uncollected amounts.

[Ask only if Section 2, Question 2 (multiple NPIs) is Yes (1):] Please report revenue only for the sampled NPI, not for your entire parent organization.

[If Section 2, Question 13 is Yes (1), show following warning: “With the exception of Question 1 where the entire revenue of your organization from all sources should be reported, you must exclude revenue from air ambulance operations when responding to questions in Section 13.”

Report criteria: Displays a total of Payments/Refunds by Payor Category and Payor Name. Revenues are categorized by the credit payor, NOT by Primary payor.